Chiari Archives - Michigan Head & Spine Institute Blog



Holly S. Gilmer, M.D.
Holly S. Gilmer, M.D.
Adult & Pediatric Neurosurgery
Peripheral Nerve Surgery

Approximately one in 1,000 people is affected by a group of brain abnormalities known as Chiari malformations. Named for Hans Chiari, the Austrian pathologist who first described them, Chiari malformations affect the brain in the place where the skull meets the spine. Brain tissue extends into the spinal canal because part of the skull is misshapen or undersized and presses the brain downward.

While it’s possible to have a Chiari malformation without knowing it, these abnormalities can cause symptoms that may affect a person’s quality of life. Understanding Chiari malformations, including potential symptoms and treatment options, can help you determine whether you might have one of these malformations.

Chiari Malformation Types and Symptoms

There are at least five types of Chiari malformations, but the most common types are Chiari I and Chiari II.  Chiari I may be congenital, or may develop over time as the brain and skull grow. The main symptom is headaches, but people may also experience:

  • Neck pain
  • Problems with balance and coordination
  • Dizziness
  • Numbness and tingling in the hands and feet
  • Trouble swallowing
  • Gagging and choking
  • Difficulty speaking clearly
  • Weakness
  • Curved spine (scoliosis)

Chiari malformation type II is congenital, meaning a person is born with it. People born with type II almost always have myelomeningocele, a type of spina bifida in which the backbone and the spinal canal don’t close properly before birth. Symptoms of type II include:

  • Difficulty breathing regularly
  • Gagging/trouble swallowing
  • Arm and leg weakness
  • Involuntary eye movements

Diagnosing Chiari Malformations  

Congenital types of Chiari malformation can often be diagnosed with an ultrasound of the unborn baby. For children and adults, the most reliable way to spot a suspected Chiari malformation is with an MRI of the brain.

Treating Chiari Malformations

Many people with Chiari malformations experience no symptoms and may not even realize they have one. Others may deal with mild or infrequent symptoms that don’t bother them or can be easily managed with over-the-counter medications like Tylenol.

For those with a Chiari malformation who’ve had symptoms for more than six months, occurring more often than not and interfering with their ability to function, surgery is an option.

Surgery to treat Chiari malformation is an inpatient procedure that requires a hospital stay of a few days. But many patients report feeling much less pain immediately after surgery and typical recovery takes about 3 – 6 weeks, but individual experiences vary.

When to See a Doctor

If you struggle with frequent headaches or other symptoms of Chiari malformation that are affecting your quality of life, consider reaching out to a specialist who can make a diagnosis. Together, you can discuss next steps, including whether you’re a good candidate for surgical treatment.

If you or a loved one is seeking treatment for Chiari malformation, or to schedule an appointment with Dr. Gilmer or any of our MHSI experts, visit or call 248-784-3667.


September marks another effort to raise awareness about Chiari malformation. Chiari malformation is a disease of the brain where brain tissue is pushed down into the spinal canal. It occurs when the base of the skull is abnormally small or misshapen, causing pressure on the brain which forces it downward. Chiari malformation may cause blockage in the flow of the cerebrospinal fluid, which may cause the normal fluid spaces in the brain to enlarge, also known as hydrocephalus.

It was estimated that the condition occurs in about one in every 1,000 births. However, the increased use of diagnostic imaging has shown that Chiari malformation may be much more common. Complicating this estimation is the fact that some children who are born with the condition may not show symptoms until adolescence or adulthood, if ever. It can also be hereditary, and often those with Chiari will recall a family member with the same symptoms. Family members such as siblings Ezra and Katelyn, and mother Tammy and daughter Sheena.

Watch Ezra and Katelyn’s journey with Chiari below:

Chiari Malformation Corrected for Mother Tina and Daughter Sheena:

Adults and children alike can go through life and from doctor to doctor, with severe symptoms and are not diagnosed until an aware physician recognizes the symptoms. Patients Tina, Lu Anna and Tyler each had a physician acknowledge their symptoms and refer them to the leading expert in Chiari decompression, Neurosurgeon Dr. Holly Gilmer.

To learn more about Chiari malformation, the symptoms, and treatments, click here.

For most patients, the diagnosis is elusive for many years until the patient meets a doctor who is aware of Chiari, and understands the symptoms presented can become more manageable with surgery. One of the goals of Conquer Chiari Walk Across America is to raise awareness and funds to support further research. At this event, patients, their families and friends, along with doctors join in to walk to raise funds every third and fourth Saturday in September.

Click the graphic below to download the flyer:

Conquer Chiari Walk Across America


If you or a loved one is experiencing symptoms of Chiari malformation, call 248-784-3667 or visit to schedule an appointment with Dr. Gilmer.



Every year, more than 200,000 people are diagnosed with Chiari Malformation, a condition where a portion of the brain pushes into the spinal column, reducing the flow of spinal fluid.

Receiving a Chiari diagnosis is often a relief just to know that the symptoms are acknowledged.

Chiari Malformation can cause severe headaches, dizziness, difficulty swallowing and more. Adults have balance issues, debilitating headaches, muscle weakness, ringing in the ears and neck pain. Infants and children experience developmental delays, gagging, vomiting or reflux, excessive drooling and irritability.

This combination of symptoms can make life miserable. Fortunately, MHSI has one of the nation’s foremost experts in the surgical treatment of Chiari Malformation, Holly Gilmer, M.D., who has the knowledge and experience in offering treatment to both adults and children. Patients have traveled as far as Colorado, Maine, and Arizona to Michigan just so they could have the best chance at a full recovery.

Amy, a kindergarten teacher, is a patient of Dr. Gilmer. Battling extreme exhaustion and migraine headaches, Amy was diagnosed with Chiari Malformation, but the first neurosurgeon she saw told her the treatment is an elective surgery. When her daughter was diagnosed with a tethered spine, Amy found Dr. Gilmer.

“I kept going to doctors and they kept telling me I was stressed out and overworked. They gave me anxiety pills,” recalled Amy.

After meeting with Dr. Gilmer and choosing Chiari decompression surgery, Amy is off her headache medications, no longer has a stiff neck and, in general, feels great.

Patients who are diagnosed with Chiari Malformation and choose neurosurgery at Michigan Head and Spine Institute have comfort in the knowledge that Dr. Gilmer literally wrote the book on Chiari Malformation and decompression surgery. Her work is referenced in medical journals and with Chiari patients all over the world.

In addition to Dr. Gilmer’s expertise, patients at MHSI are in excellent hands throughout their care, no matter what their diagnosis. Throughout the spectrum of your treatment – from making your first appointment, through diagnosis and on to surgery and recovery – every patient deserves the best. Our experience and expertise gives MHSI patients an advantage for an excellent recovery.

Watch Amy’s and Zeke’s stories in their own words